Opponents of the Affordable Care Act have spent an estimated $450 million on political ads attacking the law, outspending supporters of Obamacare 15-to-1. But a state-by-state comparison of negative ads and enrollment figures suggests the attacks ads actually increased public awareness of the healthcare program.

Niam Yaraghi, a Brookings Institution expert on the economics of healthcare, based his analysis on
recently released data (below) that tallies how much money was spent on anti-Obamacare ads in each state.

He then examined Affordable Care Act (ACA) data to determine enrollment ratios. Although more than 8 million Americans have signed-up to purchase health insurance through the marketplaces during the first open enrollment period, that number masks the tremendous variation in participation across states. For instance, while the enrollment percentage in Minnesota is slightly above 5%, in Vermont, close to 50%of all eligible individuals have signed up for Obamacare.

Yataghi found that after controlling for other state characteristics such as low per capita income population and average insurance premiums, he observed a positive association between the anti-ACA spending and enrollment:

This implies that anti-ACA ads may unintentionally increase the public awareness about the existence of a governmentally subsidized service and its benefits for the uninsured. On the other hand, an individual's prediction about the chances of repealing the ACA may be associated with the volume of advertisements against it. In the states where more anti-ACA ads are aired, residents were on average more likely to believe that Congress will repeal the ACA in the near future. People who believe that subsidized health insurance may soon disappear could have a greater willingness to take advantage of this one time opportunity.